Hyperintense areas in the cisternal segments of the cranial nerves: a magnetic resonance imaging study.

Publisher: Springer International Country of Publication: Germany NLM ID: 8608029 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1279-8517 (Electronic) Linking ISSN: 09301038 NLM ISO Abbreviation: Surg Radiol Anat Subsets: MEDLINE

Original Publication: Berlin ; New York : Springer International, c1986-

Cranial Nerves*/diagnostic imaging ; Glymphatic System*; Humans ; Magnetic Resonance Imaging/methods ; Oculomotor Nerve ; Optic Nerve

Purpose: The study aimed to explore hyperintense areas in the cisternal segments of the cranial nerves using magnetic resonance imaging (MRI).
Methods: Seventy outpatients underwent thin-sliced, coronal constructive interference steady-state (CISS) sequence and sagittal T2-weighted MRI following conventional MRI examination.
Results: With the coronal CISS sequence, hyperintense areas were located in the central parts of the olfactory bulbs in 65.7% of patients. For the intracranial optic nerve and optic chiasm, hyperintense areas were detected in 98.6% of the CISS sequences and 100% of the T2-weighted images. In the optic tract, hyperintense areas were detected in 51.4% of cases. In 35% of the patients who underwent the CISS sequence, the intracranial optic nerves were considerably compressed by the internal carotid and anterior cerebral arteries, with hyperintense areas similar to those in patients without vascular compression. Hyperintense areas of the cisternal segments of the oculomotor nerve and trigeminal root were identified in 52.9% and 87.1% of the patients, respectively.
Conclusions: The hyperintense areas found within the cisternal segments of the cranial nerves delineated on the coronal CISS sequence and sagittal T2-weighted imaging may indicate the intracranial part of the glymphatic pathway through the cranial nerves. The cranial nerves may function as part of the glymphatic pathway.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Comment in: Surg Radiol Anat. 2022 May;44(5):767-768. (PMID: 35403867)

Benveniste H, Liu X, Koundal S, Sanggaard S, Lee H, Wardlaw J (2019) The glymphatic system and waste clearance with brain aging: a review. Gerontology 65:106–119. (PMID: 10.1159/000490349)
Chen L, Elias G, Yostos MP, Stimec B, Fasel J, Murphy K (2015) Pathways of cerebrospinal fluid outflow: a deeper understanding of resorption. Neuroradiology 57:139–147. (PMID: 10.1007/s00234-014-1461-9)
Eide PK, Ringstad G (2021) Cerebrospinal fluid egress to human parasagittal dura and the impact of sleep deprivation. Brain Res 1772:147669. (PMID: 10.1016/j.brainres.2021.147669)
Fahmy LM, Chen Y, Xuan S, Haacke EM, Hu J, Jiang Q (2021) All central nervous system neuro- and vascular-communication channels are surrounded with cerebrospinal fluid. Front Neurol 12:614636. (PMID: 10.3389/fneur.2021.614636)
Jacobsen HH, Ringstad G, Jørstad ØK, Moe MC, Sandell T, Eide PK (2019) The human visual pathway communicates directly with the subarachnoid space. Invest Ophthalmol Vis Sci 60:2773–2780. (PMID: 10.1167/iovs.19-26997)
Jacobsen HH, Sandell T, Jørstad ØK, Moe MC, Ringstad G, Eide PK (2020) In vivo evidence for impaired glymphatic function in the visual pathway of patients with normal pressure hydrocephalus. Invest Ophthalmol Vis Sci 61:24. (PMID: 10.1167/iovs.61.13.24)
Killer HE, Miller NR, Flammer J, Meyer P, Weinreb RN, Remonda L, Jaggi GP (2012) Cerebrospinal fluid exchange in the optic nerve in normal-tension glaucoma. Br J Ophthalmol 96:544–548. (PMID: 10.1136/bjophthalmol-2011-300663)
Klostranec JM, Vucevic D, Bhatia KD, Kortman HGJ, Krings T, Murphy KP, terBrugge KG, Mikulis DJ (2021) Current concepts in intracranial fluid transport and the glymphatic system: Part II-imaging techniques and clinical applications. Radiology 301:516–532. (PMID: 10.1148/radiol.2021204088)
Liang C, Du X, Xu J, Wu L, Liu C, Wang X, Wang H, Yu F (2010) MR imaging of the cisternal segment of the posterior group of cranial nerves: neurovascular relationships and abnormal changes. Eur J Radiol 75:57–63. (PMID: 10.1016/j.ejrad.2009.03.036)
Mathieu E, Gupta N, Ahari A, Zhou X, Hanna J, Yücel YH (2017) Evidence for cerebrospinal fluid entry into the optic nerve via a glymphatic pathway. Invest Ophthalmol Vis Sci 58:4784–4791. (PMID: 10.1167/iovs.17-22290)
Mezey É, Szalayova I, Hogden CT, Brady A, Dósa Á, Sótonyi P, Palkovits M (2021) An immunohistochemical study of lymphatic elements in the human brain. Proc Natl Acad Sci USA 118:e2002574118. (PMID: 10.1073/pnas.2002574118)
Proulx ST (2021) Cerebrospinal fluid outflow: a review of the historical and contemporary evidence for arachnoid villi, perineural routes, and dural lymphatics. Cell Mol Life Sci 78:2429–2457. (PMID: 10.1007/s00018-020-03706-5)
Tsutsumi S, Ogino I, Miyajima M, Nakamura M, Yasumoto Y, Arai H, Ito M (2014) Cranial arachnoid protrusions and contiguous diploic veins in CSF drainage. AJNR Am J Neuroradiol 35:1735–1739. (PMID: 10.3174/ajnr.A4007)
Tsutsumi S, Ono H, Yasumoto Y (2017) Visualization of the olfactory nerve using constructive interference in steady state magnetic resonance imaging. Surg Radiol Anat 39:315–321. (PMID: 10.1007/s00276-016-1731-9)
Tsutsumi S, Fernandez-Miranda JC, Ono H, Yasumoto Y (2017) The cisternal segments of the oculomotor nerve: a magnetic resonance imaging study. Surg Radiol Anat 39:323–331. (PMID: 10.1007/s00276-016-1725-7)
Tsutsumi S, Ono H, Ishii H (2021) Hyperintense areas in the intraorbital optic nerve evaluated by T2-weighted magnetic resonance imaging: a glymphatic pathway? Surg Radiol Anat 43:1273–1278. (PMID: 10.1007/s00276-020-02649-7)
Tsutsumi S, Ono H, Ishii H (2021) Trochlear cistern of the cavernous sinus: an anatomical study using magnetic resonance imaging. Surg Radiol Anat 43:1279–1284. (PMID: 10.1007/s00276-020-02659-5)
Walter BA, Valera VA, Takahashi S, Ushiki T (2006) The olfactory route for cerebrospinal fluid drainage into the peripheral lymphatic system. Neuropathol Appl Neurobiol 32:388–396. (PMID: 10.1111/j.1365-2990.2006.00737.x)
Weller RO, Kida S, Zhang ET (1992) Pathways of fluid drainage from the brain—morphological aspects and immunological significance in rat and man. Brain Pathol 2:277–284. (PMID: 10.1111/j.1750-3639.1992.tb00704.x)
Yankova G, Bogomyakova O, Tulupov A (2021) The glymphatic system and meningeal lymphatics of the brain: new understanding of brain clearance. Rev Neurosci 32:693–705. (PMID: 10.1515/revneuro-2020-0106)

Keywords: Cistern; Cranial nerves; Glymphatic pathway; Magnetic resonance imaging

Date Created: 20220223 Date Completed: 20220330 Latest Revision: 20220629

20240829

10.1007/s00276-022-02902-1

35195771